RESUMEN
(1) Background: Branched-chain and aromatic amino acids (BCAAs/AAAs) have been considered as markers of type 2 diabetes (T2D); however, studies on associations between these metabolites and T2D and cardiometabolic traits in Hispanic populations are limited. The aim of this study was to examine the associations between baseline BCAAs (isoleucine, leucine, valine)/AAAs (phenylalanine, tyrosine) and prevalent and incident T2D, as well as baseline and longitudinal (2 year) changes in cardiometabolic traits (measures of glycemia, dyslipidemia, inflammation, and obesity) in two large cohorts of adults of Puerto Rican descent. (2) Methods: We included participants of the Boston Puerto Rican Health Study (BPRHS, n = 670) and San Juan Overweight Adult Longitudinal study (SOALS, n = 999) with available baseline metabolite and covariate data. T2D diagnosis was defined based on American Diabetes Association criteria. Multivariable logistic (for baseline T2D), Poisson (for incident T2D), and linear (for cardiometabolic traits) regression models were used; cohort-specific results were combined in the meta-analysis and adjusted for multiple comparisons. (3) Results: Higher baseline BCAAs were associated with higher odds of prevalent T2D (OR1SD BCAA score = 1.46, 95% CI: 1.34-1.59, p < 0.0001) and higher risk of incident T2D (IRR1SD BCAA score = 1.24, 95% CI: 1.13-1.37, p < 0.0001). In multivariable longitudinal analysis, higher leucine and valine concentrations were associated with 2-year increase in insulin (beta 1SD leucine = 0.37 mcU/mL, 95% CI: 0.11-0.63, p < 0.05; beta 1SD valine = 0.43 mcU/mL, 95% CI: 0.17-0.68, p < 0.01). Tyrosine was a significant predictor of incident T2D (IRR = 1.31, 95% CI: 1.09-1.58, p < 0.05), as well as 2 year increases in HOMA-IR (beta 1SD tyrosine = 0.13, 95% CI: 0.04-0.22, p < 0.05) and insulin concentrations (beta 1SD tyrosine = 0.37 mcU/mL, 95% CI: 0.12-0.61, p < 0.05). (4) Conclusions: Our results confirmed the associations between BCAAs and prevalent and incident T2D, as well as concurrent measures of glycemia, dyslipidemia, and obesity, previously reported in predominantly White and Asian populations. Baseline leucine, valine, and tyrosine were predictors of 2 year increases in insulin, whereas tyrosine was a significant predictor of deteriorating insulin resistance over time. Our study suggests that BCAAs and tyrosine could serve as early markers of future glycemic changes in Puerto Ricans.
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Aminoácidos Aromáticos , Aminoácidos de Cadena Ramificada , Factores de Riesgo Cardiometabólico , Diabetes Mellitus Tipo 2 , Hispánicos o Latinos , Humanos , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/sangre , Femenino , Masculino , Persona de Mediana Edad , Aminoácidos de Cadena Ramificada/sangre , Aminoácidos Aromáticos/sangre , Adulto , Hispánicos o Latinos/estadística & datos numéricos , Estudios Longitudinales , Puerto Rico/epidemiología , Puerto Rico/etnología , Anciano , Prevalencia , Boston/epidemiología , Incidencia , Obesidad/epidemiología , Obesidad/etnologíaRESUMEN
INTRODUCTION: Recent studies have implicated acetyl-L-carnitine as well as other acylcarnitines in depression. To our knowledge, no untargeted metabolomics studies have been conducted among US mainland Puerto Ricans. OBJECTIVES: We conducted untargeted metabolomic profiling on plasma from 736 participants of the Boston Puerto Rican Health Study. METHODS: Using Weighted Gene Co-expression Network Analysis, we identified metabolite modules associated with depressive symptomatology, assessed via the Center for Epidemiologic Studies Depression scale. We identified metabolites contributing to these modules and assessed the relationship between these metabolites and depressive symptomatology. RESULTS: 621 annotated metabolites clustered into eight metabolite modules, of which one, the acylcarnitine module, was significantly inversely associated with depressive symptomatology (ß = - 27.7 (95% CI (- 54.5-0.8); p = 0.043). Several metabolite hub features in the acylcarnitine module were significantly associated with depressive symptomatology, after correction for multiple comparisons. CONCLUSIONS: In this untargeted plasma metabolomics study among mainland Puerto Rican older adults, acylcarnitines, as a metabolite module were inversely associated with depressive symptomatology.
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Carnitina , Depresión , Metabolómica , Humanos , Carnitina/análogos & derivados , Carnitina/sangre , Carnitina/metabolismo , Femenino , Masculino , Depresión/sangre , Depresión/metabolismo , Metabolómica/métodos , Persona de Mediana Edad , Anciano , Puerto Rico , Estudios de Cohortes , Hispánicos o Latinos , Boston/epidemiologíaRESUMEN
AIMS/HYPOTHESIS: Many studies have examined the relationship between plasma metabolites and type 2 diabetes progression, but few have explored saliva and multi-fluid metabolites. METHODS: We used LC/MS to measure plasma (n=1051) and saliva (n=635) metabolites among Puerto Rican adults from the San Juan Overweight Adults Longitudinal Study. We used elastic net regression to identify plasma, saliva and multi-fluid plasma-saliva metabolomic scores predicting baseline HOMA-IR in a training set (n=509) and validated these scores in a testing set (n=340). We used multivariable Cox proportional hazards models to estimate HRs for the association of baseline metabolomic scores predicting insulin resistance with incident type 2 diabetes (n=54) and prediabetes (characterised by impaired glucose tolerance, impaired fasting glucose and/or high HbA1c) (n=130) at 3 years, along with regression from prediabetes to normoglycaemia (n=122), adjusting for traditional diabetes-related risk factors. RESULTS: Plasma, saliva and multi-fluid plasma-saliva metabolomic scores predicting insulin resistance included highly weighted metabolites from fructose, tyrosine, lipid and amino acid metabolism. Each SD increase in the plasma (HR 1.99 [95% CI 1.18, 3.38]; p=0.01) and multi-fluid (1.80 [1.06, 3.07]; p=0.03) metabolomic scores was associated with higher risk of type 2 diabetes. The saliva metabolomic score was associated with incident prediabetes (1.48 [1.17, 1.86]; p=0.001). All three metabolomic scores were significantly associated with lower likelihood of regressing from prediabetes to normoglycaemia in models adjusting for adiposity (HRs 0.72 for plasma, 0.78 for saliva and 0.72 for multi-fluid), but associations were attenuated when adjusting for lipid and glycaemic measures. CONCLUSIONS/INTERPRETATION: The plasma metabolomic score predicting insulin resistance was more strongly associated with incident type 2 diabetes than the saliva metabolomic score. Only the saliva metabolomic score was associated with incident prediabetes.
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Diabetes Mellitus Tipo 2 , Progresión de la Enfermedad , Resistencia a la Insulina , Metabolómica , Estado Prediabético , Saliva , Humanos , Saliva/metabolismo , Saliva/química , Resistencia a la Insulina/fisiología , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Estado Prediabético/metabolismo , Estado Prediabético/sangre , Adulto , Estudios Longitudinales , Anciano , Hispánicos o Latinos , Puerto Rico/epidemiologíaRESUMEN
(1) Aims: Gut microbiota metabolites may play integral roles in human metabolism and disease progression. However, evidence for associations between metabolites and cardiometabolic risk factors is sparse, especially in high-risk Hispanic populations. We aimed to evaluate the cross-sectional and longitudinal relationships between gut microbiota related metabolites and measures of glycemia, dyslipidemia, adiposity, and incident type 2 diabetes in two Hispanic observational cohorts. (2) Methods: We included data from 670 participants of the Boston Puerto Rican Health Study (BPRHS) and 999 participants of the San Juan Overweight Adult Longitudinal Study (SOALS). Questionnaires and clinical examinations were conducted over 3 years of follow-up for SOALS and 6 years of follow-up for BPRHS. Plasma metabolites, including L-carnitine, betaine, choline, and trimethylamine N-oxide (TMAO), were measured at baseline in both studies. We used multivariable linear models to evaluate the associations between metabolites and cardiometabolic risk factors and multivariable logistic and Poisson regressions to assess associations with prevalent and incident type 2 diabetes, adjusted for potential confounding factors. Cohort-specific analyses were combined using a fixed-effects meta-analysis. (3) Results: Higher plasma betaine was prospectively associated with lower fasting glucose [-0.97 mg/dL (95% CI: -1.59, -0.34), p = 0.002], lower HbA1c [-0.02% (95% CI: -0.04, -0.01), p = 0.01], lower HOMA-IR [-0.14 (95% CI: -0.23, -0.05), p = 0.003], and lower fasting insulin [-0.27 mcU/mL (95% CI: -0.51, -0.03), p = 0.02]. Betaine was also associated with a 22% lower incidence of type 2 diabetes (IRR: 0.78, 95% CI: 0.65, 0.95). L-carnitine was associated with lower fasting glucose [-0.68 mg/dL (95% CI: -1.29, -0.07), p = 0.03] and lower HbA1c at follow-up [-0.03% (95% CI: -0.05, -0.01), p < 0.001], while TMAO was associated with higher fasting glucose [0.83 mg/dL (95% CI: 0.22, 1.44), p = 0.01] and higher triglycerides [3.52 mg/dL (95% CI: 1.83, 5.20), p < 0.0001]. Neither choline nor TMAO were associated with incident type 2 diabetes. (4) Conclusions: Higher plasma betaine showed consistent associations with a lower risk of glycemia, insulinemia, and type 2 diabetes. However, TMAO, a metabolite of betaine, was associated with higher glucose and lipid concentrations. These observations demonstrate the importance of gut microbiota metabolites for human cardiometabolic health.
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Diabetes Mellitus Tipo 2 , Microbioma Gastrointestinal , Hispánicos o Latinos , Metilaminas , Adulto , Humanos , Betaína , Carnitina , Colina , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/etnología , Glucosa , Hemoglobina Glucada , Hispánicos o Latinos/etnología , Hispánicos o Latinos/estadística & datos numéricos , Estudios Longitudinales , Puerto Rico/epidemiología , Puerto Rico/etnología , Boston/epidemiologíaRESUMEN
BACKGROUND: The global diet quality score (GDQS) is a simple, standardized metric appropriate for population-based measurement of diet quality globally. OBJECTIVES: We aimed to operationalize data collection by modifying the quantity of consumption cutoffs originally developed for the GDQS food groups and to statistically evaluate the performance of the operationalized GDQS relative to the original GDQS against nutrient adequacy and noncommunicable disease (NCD)-related outcomes. METHODS: The GDQS application uses a 24-h open-recall to collect a full list of all foods consumed during the previous day or night, and automatically classifies them into corresponding GDQS food group. Respondents use a set of 10 cubes in a range of predetermined sizes to determine if the quantity consumed per GDQS food group was below, or equal to or above food group-specific cutoffs established in grams. Because there is only a total of 10 cubes but as many as 54 cutoffs for the GDQS food groups, the operationalized cutoffs differ slightly from the original GDQS cutoffs. RESULTS: A secondary analysis using 5 cross-sectional datasets comparing the GDQS with the original and operationalized cutoffs showed that the operationalized GDQS remained strongly correlated with nutrient adequacy and was equally sensitive to anthropometric and other clinical measures of NCD risk. In a secondary analysis of a longitudinal cohort study of Mexican teachers, there were no differences between the 2 modalities with the beta coefficients per 1 SD change in the original and operationalized GDQS scores being nearly identical for weight gain (-0.37 and -0.36, respectively, P < 0.001 for linear trend for both models) and of the same clinical order of magnitude for waist circumference (-0.52 and -0.44, respectively, P < 0.001 for linear trend for both models). CONCLUSION: The operationalized GDQS cutoffs did not change the performance of the GDQS and therefore are recommended for use to collect GDQS data in the future.
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Dieta Saludable/métodos , Dieta , Programas Informáticos , Bebidas/clasificación , Estudios Transversales , Recolección de Datos/métodos , Registros de Dieta , Dieta Saludable/normas , Alimentos/clasificación , Humanos , Recuerdo Mental , México/epidemiología , Enfermedades no Transmisibles/epidemiología , Estado Nutricional , Programas Informáticos/estadística & datos numéricosRESUMEN
BACKGROUND: The Global Diet Quality Score (GDQS) is intended as a simple global diet quality metric feasible in low- and middle-income countries facing the double burden of malnutrition. OBJECTIVE: The aim of this study was to evaluate the performance of the GDQS with markers of nutrient adequacy and chronic disease in nonpregnant nonlactating (NPNL) Mexican women of reproductive age and to compare it with the Alternate Healthy Eating Index-2010 (AHEI-2010) and the Minimum Dietary Diversity for Women (MDD-W). METHODS: We included NPNL women aged 15 to 49 y from the Mexican National Health and Nutrition Surveys (2012 and 2016) with 24-h recall (n = 2542) or a FFQ (n = 4975) (separate samples). We evaluated the correlation of the GDQS with the energy-adjusted intake of several nutrients and evaluated its association with health parameters using covariate-adjusted linear regression models. RESULTS: The GDQS was positively correlated with the intake of calcium, folate, iron, vitamin A, vitamin B-12, zinc, fiber, protein, and total fat (rho = 0.09 to 0.38, P < 0.05) and was inversely correlated with the intake of added sugar (rho = -0.37 and -0.38, P < 0.05) using both instruments, and with total fat, SFA, and MUFA only with 24-h recall data (rho = -0.06 to -0.16, P < 0.05). The GDQS was inversely associated with serum ferritin, BMI, waist circumference, and serum total and LDL cholesterol using FFQ data (P < 0.05), and was positively associated with serum folate using 24-h recall data (P < 0.05). Similar correlations and associations were observed with the MDD-W (only with micronutrients) and the AHEI-2010 (only with chronic disease-related nutrients and health markers). CONCLUSIONS: In comparison to other diet metrics, the GDQS can capture both dimensions of nutrient adequacy and health markers related to the risk of chronic disease. The performance of the GDQS was satisfactory with either 24-h recall or FFQ.
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Dieta Saludable , Dieta , Estado de Salud , Estado Nutricional , Adolescente , Adulto , Antropometría , LDL-Colesterol/sangre , Registros de Dieta , Ingestión de Alimentos , Femenino , Ferritinas/sangre , Ácido Fólico/sangre , Humanos , Recuerdo Mental , México , Micronutrientes/administración & dosificación , Persona de Mediana Edad , Encuestas Nutricionales , Adulto JovenRESUMEN
BACKGROUND: Evidence on concurrent changes in overall diet quality and weight and waist circumference in women of reproductive age from low- and middle-income countries is limited. OBJECTIVES: We examined the associations of changes in the Global Diet Quality Score (GDQS) and each GDQS food group with concurrent weight and waist circumference change in Mexican women. METHODS: We followed prospectively 8967 nonpregnant nonlactating women aged 25-49 y in the Mexican Teachers' Cohort between 2006 and 2008. We assessed diet using an FFQ of the previous year and anthropometric measures were self-reported. Regression models were used to examine 2-y changes in the GDQS and each food group (servings/d) with weight and waist circumference changes within the same period, adjusting for demographic and lifestyle factors. RESULTS: Compared with those with little change in the GDQS (-2 to 2 points), women with the largest increase in the GDQS (>5 points) had less weight (ß: -0.81 kg/2 y; 95% CI: -1.11, -0.51 kg/2 y) and waist circumference gain (ß: -1.05 cm/2 y; 95% CI: -1.62, -0.48 cm/2 y); likewise, women with the largest decrease in the GDQS (<-5 points) had more weight (ß: 0.36 kg/2 y; 95% CI: 0.06, 0.66 kg/2 y) and waist circumference gain (ß: 0.71 cm/2 y; 95% CI: 0.09, 1.32 cm/2 y). Increased intake of dark green leafy vegetables, cruciferous vegetables, deep orange vegetables, citrus fruits, and fish and shellfish was associated with less weight gain. In addition, deep orange vegetables, low fat and high fat dairy, whole grains, and fish were associated with less waist circumference gain within the 2-y period. CONCLUSIONS: Improvements in diet quality over a 2-y period reflected by an increase in the GDQS and changes in consumption of specific components of the GDQS were associated with less weight and waist circumference gain in Mexican women.
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Peso Corporal , Dieta Saludable/tendencias , Dieta/tendencias , Circunferencia de la Cintura , Adulto , Femenino , Humanos , Estudios Longitudinales , México , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
BACKGROUND: Minorities, including mainland Puerto Ricans, are impacted disproportionally by Alzheimer's disease (AD), dementia, and cognitive decline. Studying blood metabolomics in this population has the potential to probe the biological underpinnings of this health disparity. OBJECTIVE: We performed a comprehensive analysis of circulating plasma metabolites in relation to cognitive function in 736 participants from the Boston Puerto Rican Health Study (BPRHS) who underwent untargeted mass-spectrometry based metabolomics analysis and had undergone a battery of in-person cognitive testing at baseline. METHODS: After relevant exclusions, 621 metabolites were examined. We used multivariable regression, adjusted for age, sex, education, apolipoprotein E genotype, smoking, and Mediterranean dietary pattern, to identify metabolites related to global cognitive function in our cohort. LASSO machine learning was used in a complementary analysis to identify metabolites that could discriminate good from poor extremes of cognition. We also conducted sensitivity analyses: restricted to participants without diabetes, and to participants with good adherence to Mediterranean diet. RESULTS: Of 621 metabolites, FDR corrected (pâ<â0.05) multivariable linear regression identified 3 metabolites positively, and 10 negatively, associated with cognitive function in the BPRHS. In a combination of FDR-corrected linear regression, logistic regression regularized via LASSO, and sensitivity analyses restricted to participants without diabetes, and with good adherence to the Mediterranean diet, ß-cryptoxanthin plasma concentration was consistently associated with better cognitive function and N-acetylisoleucine and tyramine O-sulfate concentrations were consistently associated with worse cognitive function. CONCLUSION: This untargeted metabolomics study identified potential biomarkers for cognitive function in a cohort of Puerto Rican older adults.
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Cognición/fisiología , Disfunción Cognitiva/sangre , Disfunción Cognitiva/metabolismo , Diabetes Mellitus/sangre , Anciano , Estudios de Cohortes , Dieta Mediterránea/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Puerto Rico , Factores de RiesgoRESUMEN
BACKGROUND: Although individual healthy lifestyle behaviors may reduce cardiovascular disease risk, few studies have analyzed the combined effect of multiple lifestyle components as one all-inclusive measure on such outcomes, much less in minority populations. OBJECTIVE: We aimed to develop a Healthy Lifestyle Score (HLS) that included several lifestyle recommendations and to test its association with metabolic syndrome (MetS) and allostatic load (AL) and their cardiometabolic and neuroendocrine factors in Puerto Ricans. METHODS: In a cross-sectional study in 787 Puerto Ricans living in Boston (aged 45-75 y), we developed an HLS that ranged from 0 to 190 (higher score indicative of healthier lifestyle) and included 5 components (diet, physical activity and sedentary behaviors, smoking, social support and network, and sleep). Multivariable-adjusted models were used to test associations between the HLS and biomarkers of dysregulation and odds of MetS and high AL (≥4 out of 10 components). RESULTS: The HLS showed adequate internal consistency (ρ = 0.31-0.69) and was inversely associated with urinary cortisol (ß ± SE = -0.22 ± 0.11; P = 0.042), epinephrine (-0.20 ± 0.09; P = 0.017), and norepinephrine (-0.26 ± 0.11; P = 0.016); waist circumference (-0.014 ± 0.004; P = 0.003); and serum insulin (-0.30 ± 0.13; P = 0.028) and positively associated with plasma HDL cholesterol (0.007 ± 0.003; P = 0.021) after adjustment for potential confounders. For each 20-unit increase in HLS, participants had 19% (95% CI: 2%, 33%) and 25% (11%, 36%) lower odds of MetS or AL, respectively. Healthier scores for social support and network and smoking components were associated with lower odds of high AL (P < 0.005). No significant associations were observed for other individual lifestyle components. CONCLUSIONS: Following an overall healthy lifestyle that comprises a combination of multiple behaviors may provide stronger protection against MetS and AL in Puerto Rican adults than individual components. The HLS may be a useful tool for examining health-related outcomes. This trial was registered at clinicaltrials.gov as NCT01231958.
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Enfermedades Cardiovasculares/epidemiología , Conducta Alimentaria , Conductas Relacionadas con la Salud , Estilo de Vida , Síndrome Metabólico/epidemiología , Anciano , Alostasis , Boston , Estudios Transversales , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Actividad Motora , Puerto Rico , Factores de Riesgo , Factores Socioeconómicos , Circunferencia de la CinturaRESUMEN
BACKGROUND: Cardiovascular disease (CVD) and osteoporosis are 2 major public health problems that share common pathophysiological mechanisms. It is possible that strategies to reduce CVD risk may also benefit bone health. OBJECTIVE: We tested the hypothesis that adherence to the 2006 American Heart Association Diet and Lifestyle Recommendations (AHA-DLR) is associated with bone health. DESIGN: We previously developed a unique diet and lifestyle score (American Heart Association Diet and Lifestyle Score; AHA-DLS) to assess adherence to the AHA-DLR. In a cross-sectional study of 933 Puerto Ricans aged 47-79 y, we modified the AHA-DLS to test associations with bone health. Bone mineral density (BMD) at the femoral neck, trochanter, total hip, and lumbar spine (L2-L4) was measured by using dual-energy X-ray absorptiometry. RESULTS: For every 5-unit increase in the modified AHA-DLS, BMD at the femoral neck, trochanter, total hip, and lumbar spine (L2-L4) was associated with a 0.005-0.008-g/cm(2) (P < 0.05) higher value. No component of the AHA-DLR alone was responsible for the observed positive associations. For every 5-unit increase in the modified AHA-DLS, the odds for osteoporosis or osteopenia at the trochanter, total hip, and lumbar spine (L2-L4) were lower by 14% (OR: 0.86; 95% CI: 0.79, 0.92), 17% (OR: 0.83; 95% CI: 0.76, 0.92), and 9% (OR: 0.91; 95% CI: 0.84, 0.99), respectively. CONCLUSIONS: Dietary guidelines for CVD risk reduction may also benefit bone health in this Hispanic cohort. Synchronizing dietary guidelines for these 2 common diseases may provide a simplified public health message. This trial was registered at clinicaltrials.gov as NCT01231958.
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Densidad Ósea , Huesos/metabolismo , Enfermedades Cardiovasculares/prevención & control , Dieta , Estilo de Vida , Cooperación del Paciente , Absorciometría de Fotón , Anciano , American Heart Association , Huesos/diagnóstico por imagen , Boston/epidemiología , Enfermedades Cardiovasculares/etnología , Estudios Transversales , Conducta Alimentaria , Femenino , Guías como Asunto , Hispánicos o Latinos , Humanos , Modelos Logísticos , Vértebras Lumbares , Masculino , Persona de Mediana Edad , Evaluación Nutricional , Osteoporosis/diagnóstico por imagen , Osteoporosis/prevención & control , Estudios Prospectivos , Puerto Rico/etnología , Factores de Riesgo , Estados UnidosRESUMEN
Higher variety in fruit and vegetable intake has been associated with a lower risk of several chronic diseases. It remains unclear whether such associations exist relating to cognition. The authors examined associations between total quantity and variety in fruit and vegetable intake and cognitive function in a cross-sectional sample of 1412 Puerto Rican adults, aged 45-75 years from the Boston Puerto Rican Health Study, 2004-9. Fruit and vegetable intake was assessed with a FFQ. Cognitive function was measured with a battery of seven tests; the Mini Mental State Examination (MMSE) was administrated to assess global cognitive function. Greater variety, but not total quantity, of fruit and vegetable intake was associated with a higher MMSE score after multivariate adjustment (P for trend = 0·012). This association remained significant after further adjusting for total quantity of fruit and vegetable intake (P for trend = 0·018). High variety of fruit and vegetable intake was also associated with individual cognitive domains, including executive function, memory and attention (all P for trend < 0·05). Variety, more than total quantity, of fruit and vegetable intake may offer cognitive protection in middle-aged and older adults, but longitudinal studies are needed to clarify direction of causality.
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Envejecimiento , Disfunción Cognitiva/prevención & control , Dieta , Conducta Alimentaria , Frutas , Verduras , Anciano , Bebidas , Boston , Disfunción Cognitiva/etnología , Disfunción Cognitiva/etiología , Estudios Transversales , Dieta/efectos adversos , Dieta/etnología , Conducta Alimentaria/etnología , Femenino , Encuestas Epidemiológicas , Hispánicos o Latinos , Humanos , Masculino , Persona de Mediana Edad , Valor Nutritivo , Puerto Rico/etnología , Estadística como Asunto , Salud Urbana/etnologíaRESUMEN
BACKGROUND: Fat mass is thought to be protective against osteoporosis, primarily because of its weight-bearing effect. Few studies have evaluated the association between abdominal fat mass (AFM) and bone health beyond its weight-bearing effect. OBJECTIVE: We tested the hypothesis that higher body weight-adjusted AFM is associated with poor bone health. DESIGN: A cross-sectional study was conducted in 629 Puerto Rican adults aged 47-79 y. Bone mineral density (BMD) of the femoral neck, trochanter, total femur, and lumbar spine (L2-L4) were measured by using dual-energy X-ray absorptiometry (DXA). AFM and total fat mass (TFM) were assessed by using body-composition software from whole-body DXA scans. Osteoporosis and osteopenia were defined as T-scores ≤ -2.5 and -1.0 to -2.5 SD, respectively, at the respective bone site. RESULTS: After confounders were controlled for, body weight-adjusted AFM was inversely associated with BMD at all 4 bone sites in women and at the femoral neck in men. For TFM, small inverse associations were seen at the trochanter and total femur in women. In men, similar associations were seen at the 3 femur sites. In both sexes, the odds for osteoporosis or osteopenia at each of the femoral sites increased by 10-16% for every 100-g increase in body weight-adjusted AFM. CONCLUSIONS: Higher AFM was associated with poor bone health in this Puerto Rican sample. Efforts to reduce abdominal obesity will not only reduce the risk of chronic disease but may also improve bone health. This trial is registered at clinicaltrials.gov as NCT01231958.
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Grasa Abdominal/patología , Densidad Ósea , Resorción Ósea/etnología , Resorción Ósea/etiología , Obesidad Abdominal/fisiopatología , Adiposidad , Anciano , Índice de Masa Corporal , Enfermedades Óseas Metabólicas/epidemiología , Enfermedades Óseas Metabólicas/etnología , Enfermedades Óseas Metabólicas/etiología , Resorción Ósea/epidemiología , Boston/epidemiología , Estudios de Cohortes , Estudios Transversales , Femenino , Estudios de Seguimiento , Hispánicos o Latinos , Humanos , Masculino , Persona de Mediana Edad , Obesidad Abdominal/patología , Osteoporosis/epidemiología , Osteoporosis/etnología , Osteoporosis/etiología , Puerto Rico/etnología , Factores de Riesgo , Factores SexualesRESUMEN
In 2006, the AHA released diet and lifestyle recommendations (AHA-DLR) for cardiovascular disease (CVD) risk reduction. The effect of adherence to these recommendations on CVD risk is unknown. Our objective was to develop a unique diet and lifestyle score based on the AHA-DLR and to evaluate this score in relation to available CVD risk factors. In a cross-sectional study of Puerto Rican adults aged 45-75 y living in the greater Boston area, information was available for the following variables: diet (semiquantitative FFQ), blood pressure, waist circumference (WC), 10-y risk of coronary heart disease (CHD) (Framingham risk score), and fasting plasma lipids, serum glucose, insulin, and C-reactive protein (CRP) concentrations. We developed a diet and lifestyle score (AHA-DLS) based on the AHA-DLR. The AHA-DLS had both internal consistency and content validity. It was associated with plasma HDL cholesterol (P = 0.001), serum insulin (P = 0.0003), and CRP concentrations (P = 0.02), WC (P < 0.0001), and 10-y risk of CHD score (P = 0.01 in women). The AHA-DLS was inversely associated with serum glucose among those with a BMI < 25 (P = 0.01). Women and men in the highest quartile of the AHA-DLS had lower serum insulin (P-trend = 0.0003) and CRP concentrations (P-trend = 0.002), WC (P-trend = 0.0003), and higher HDL cholesterol (P-trend = 0.008). The AHA-DLS is a useful tool to measure adherence to the AHA-DLR and may be used to examine associations between diet and lifestyle behaviors and CVD risk.
Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Dieta/efectos adversos , Estilo de Vida/etnología , Aculturación , Anciano , American Heart Association , Boston/epidemiología , Enfermedades Cardiovasculares/prevención & control , Estudios Transversales , Dieta/etnología , Femenino , Guías como Asunto , Promoción de la Salud , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Actividad Motora , Cooperación del Paciente , Puerto Rico/etnología , Riesgo , Estados UnidosRESUMEN
BACKGROUND: Puerto Rican adults have prevalent metabolic abnormalities, but few studies have explored fruit and vegetable (FV) intake and coronary heart disease (CHD) risk in this population. OBJECTIVE: We tested the hypothesis that greater FV intake and variety are associated with a lower 10-y risk of CHD and C-reactive protein (CRP) concentrations. DESIGN: In a cross-sectional study of ≈1200 Puerto Rican adults aged 45-75 y, we assessed FV intake with a food-frequency questionnaire. The 10-y risk of CHD was assessed with the Framingham risk score (FRS) in participants free of cardiovascular disease. CRP was measured in fasting serum. RESULTS: Variety, but not quantity, of FV intake was inversely associated with FRS after adjustment for the following: sex; waist circumference; perceived stress; alcohol use; intakes of energy, trans fatty acids, and saturated fatty acids; and use of supplements, cardiovascular medications, and diabetes medications (P = 0.02). However, the association was attenuated after adjustment for income (P = 0.11). Variety, but not quantity, was associated with a lower serum CRP concentration after adjustment for age, sex, smoking status, alcohol use, servings of FV, white blood cell count, diastolic blood pressure, diabetes, nonsteroidal antiinflammatory medication use, intakes of energy and vitamin B-6, waist circumference, perceived stress, and income. The adjusted odds of a high CRP concentration for those in the highest compared with the lowest tertile of FV variety was 0.68 (95% CI: 0.49, 0.94). CONCLUSIONS: FV variety, but not quantity, appears to be important in reducing inflammation. Although the results are suggestive, larger studies are needed to confirm a possible association with CHD risk score.